Certainly nursing is very far superior, now-a-days, to what it was in the régime of the untrained Sairey Gamp confraternity; but while gladly recognising that fact, I am inclined to think that there is still some room for improvement. For one thing, I doubt whether any particular care is taken to impress upon nurses the important fact that no two human beings are exactly the same; and that people's characteristic peculiarities are never in greater need of being studied and humoured, than when pain and sickness have weakened the will and rendered the nerves unwontedly sensitive and irritable. If this were insisted upon as it might be in the training of nurses, I do not imagine it would be as common as it is to find them performing their duties mechanically, and apparently regarding patients as machines to be wound up, regulated, and treated according to fixed principles applying to all alike, instead of as living men and women, possessing widely-differing peculiarities of both mind and body. I think that one or two of my own experiences whilst at the hospital will show that there is some reason for this criticism.
The prolonged thirst from which I had suffered, and the exertion involved in my endeavour to relieve it, fatigued me greatly in my enfeebled condition. Then came the mental wear and tear of terror which I underwent during Nurse Mary's alarmingly vigorous bedclothes-straightening process; and thus, what with one thing and another, by the time she left me to myself again I felt completely worn out, and anxious for nothing so much as sleep. In vain, however, did I try to compose myself to slumber. I was feverish; I ached all over; and, turn which way I would, I could get no ease. Each new position that I tried seemed more uncomfortable than the last; and though the cradle in which my broken leg was fixed prevented me from moving far, yet within the narrow space to which I was thus restricted, I kept shifting my place, and twisting to and fro incessantly.
Of course this restlessness was by no means conducive to my welfare; and when the doctor visited me in the morning he pronounced me to be in a very exhausted state, and said I was to have nourishment and stimulants every two hours.
I cannot say that I took kindly to the idea of being stuffed like this; for I was so far from being hungry that my gorge rose at the mere thought of food. And when the nurse who had succeeded Nurse Mary in charge of the ward came up to me with a cup of broth in her hand, I had about the same amount of inclination for it that fair Rosamond may be supposed to have had for the potion presented to her by Queen Eleanor.
But I had fully made up my mind to get well as soon as possible, and had the sense to know that I certainly could not recover without eating, so I struggled to overcome the internal rising of which I was conscious. Perhaps, too, the broth would tempt my appetite, so that after I had got down a mouthful or so, I should find the aversion to food pass away, and be able to go on eating easily. And thus resolved to do my best to obey the doctor's orders, I took a sip out of the cup.
But the first taste was a shock to me. It was not in the least like what I expected, somehow, though I was not just then clear-headed enough to discover immediately what was wrong with it. I did not believe it was broth at all; at all events, if it was, it was the nastiest that I had ever tasted in my life. I could hardly swallow even the small quantity I had taken; and as for getting down any more of it—pah! the thing was impossible. My loathing for food became more violent than ever, and I pushed away the cup feebly, saying: "Take the nasty stuff away! I can't eat it; and it'll only make me sick to try."
"Nasty indeed!" returned the nurse; "why, what better would you have than beautiful chicking-broth like this? You can drink it well enough if you like; it's only your fancy as you can't."
"I don't think it beautiful at all," replied I; "indeed, indeed, it's nasty. Do pray let me alone; perhaps I shall be hungrier by and by."
"Rubbish!" she answered, again advancing the cup towards me; "its the doctor's orders for you to be fed, and fed you shall be—even if I have to drench you. Come now; down with it!"
At this moment, when I was ruefully contemplating the broth and wondering if it would be anyhow possible for me to gulp it down, the Sister whom I had seen in the night came into the room. She was general superintendent of the nursing all through the hospital, and had a keen eye for anything amiss. My unhappy look at once attracted her attention, and she came to us and asked the nurse what she was giving me.
"Chicking broth, with a tablespoon of whisky in it, Sister," responded the woman; "that's what the doctor ordered for her. But she's making as much fuss as if it was—I don't know what, and declaring as it'll make her sick."
"I can quite understand your objecting to eat," said the Sister, addressing me gently; "people so often do when they're ill. But it's the beginning is the great difficulty with them, and after that they generally get on much better; I daresay you'll find it so if you try. Or is broth a thing to which you have any special dislike? and do you think you would fancy some other kind of food more?"
"No; I like broth well enough in general," answered I, "and I have tried to eat what the nurse brought me. But I couldn't, indeed—it is too nasty."
"Well, suppose I see if I can find anything the matter with it," she said, taking the cup from the nurse. "Why! did you ask to have it cold?"
"No," replied I.
"Did the doctor say it was to be given cold?" she inquired, turning to the nurse.
"He didn't say nothing one way or other," answered the latter; "and as I had a jugful cold, ready by me, I just took and poured some into the cup to give as it was—not thinking as it mattered."
"Oh, but it does matter, very much," returned the Sister; "broth is far nicer hot than cold. Go and warm this, and then see if the patient doesn't find it easier to get down. And don't forget in future that broth should always be given hot, unless there are special orders to the contrary."
Now surely the woman might have known that of herself, if she had taken the trouble to think for a moment, and might have perceived that cold chicken broth, with whisky in it, was a thing that no ordinary human palate could be expected to relish. But no; the doctor had not specified it was to be hot; she had some cold to hand; the question of trying to make it palatable never entered her head; and therefore, though the warming would have been but very little trouble, she just brought it me as it was. In that condition I doubt whether I could possibly have eaten it; when warmed, however, I was able to get through the requisite portion—though even then not without considerable difficulty, in consequence of my aversion to food of any kind.
Thus a second time was the conviction forced upon me that the existence in the world of Sisters might perhaps not be so altogether devoid of utility as I had previously imagined.
I daresay the food did me good; but yet it did not procure me the rest for which I craved, and I had to endure hours more of miserable tossing about before my weary body at last hit upon the posture which would best accommodate its numerous aches and bruises. With a sigh of satisfaction I gave myself up to repose, intending not to stir hand or foot as long as I remained comfortable, lest, if I once lost the position which had been so hard to find, I might not again succeed in discovering it. Soon a delicious sense of drowsiness stole over me, and I was on the point of falling sound asleep, when I was aroused by the voice of a nurse, telling me it was time to feed again. If my repugnance to eating had made all the previous feeding-times during the day objectionable to me, it may be imagined that the present summons was doubly odious, coming at the very moment when I could not bear the idea of stirring so much as a hair's-breadth from where I lay, and would have given the world to be left in peace. Dismayed at the prospect of immediate movement, and loath to be parted from the long-sought rest which I had at length attained, I appealed for a reprieve—however brief. I was so very tired of being uncomfortable, I said. I had had such a weary tossing about all night and all day till now. And now that I had at last found some comfort, might not I stay as I was for just five minutes more?
But the nurse would not hear of such a thing. The doctor's orders, she said, were for me to have food every two hours. The last time had been at 1.25—there it was marked on the slate by the bed—and now it was 3.25. Her business was to obey the doctor's orders exactly; and I must just take what she had brought me that instant, and make no more fuss about it.
So my appeal was disregarded, and I was, then and there, ruthlessly routed up to be fed. And as my nervous system was by no means robust enough at that moment to bear the shock of any abrupt disturbance, I immediately afterwards relapsed into the same state of miserable, feverish restlessness as before.
Now, though it seems unreasonable to blame any one for strict obedience to orders, yet I think in a case like this the woman might well have departed from them so far as to grant the five minutes delay for which I pleaded. It would have softened the blow to have time to make up my mind gradually to the moving which I dreaded; and I think her own sense might have told her that I was in a condition when rest was essential, and when everything unpleasant should be smoothed over to me as much as possible. But though she was not wilfully harsh or unkind, yet the advisability of making small concessions to an invalid's weakness—fancifulness, as she called it—never entered her head. All she thought of was that she was there to carry out the doctor's orders, and that provided they were obeyed to the letter, come what might, she would have nothing to reproach herself with. As for the idea of there being any special necessity for a nurse to be quick in reading, understanding, and making allowances for the fancies, infirmities, and idiosyncrasies of human nature, because she is professionally brought into constant contact with it when in its greatest need of sympathy—why, I do not suppose such a notion had ever occurred to her. But might it not have formed a part of her professional education?
I hope that my criticisms will not be misunderstood. If I venture to point out defects which seem to me remediable, it does not therefore follow that I fail to do justice to the enormous benefits which we derive from trained nurses. On the contrary, when I look back upon my sojourn at the hospital, I feel grateful for and astonished at the punctilious care and attention which was shown towards a mere friendless, helpless, unknown nobody such as I was, from whom no return could be expected. It may be that I have known nurses act hastily under provocation; that I think them apt to be hard, because too mechanical; and that I doubt whether they always bring their brains to bear as much as might be on the performance of their duty. But none the less do I believe that they are, as a body, a thoroughly conscientious, well-meaning, and valuable set of women; and that a nurse who behaves with deliberate cruelty, or wantonly neglects a patient, is hardly ever to be met with.
In speaking well, however, of the hospital attendants and the treatment I received from them, I must except Nurse Mary. She was a careless, good-for-nothing nurse, unfit for her post, constantly asleep on duty, bad tempered to the patients, and quite regardless of truth in what she said. I was unfortunate enough to be an especial object of her animosity, because she had been reprimanded and fined for her neglect of me and false excuses on the night when I had first become acquainted with her. As it had been on account of me that she had got into hot water, she took a dislike to me then and there, and took advantage of our relative positions to make me feel her displeasure. A nurse has plenty of opportunities for thwarting, bullying, and inflicting small miseries on a patient; and Nurse Mary always availed herself of these opportunities as freely as she dared. Whatever she had to do for me was sure to be done as roughly and disagreeably as possible, and I looked forward with dread to the periods when the ward I inhabited was under her charge.
Unluckily for me, it was on one of these occasions that it fell to my lot to have to take a dose of castor oil. Now, that is a physic to which I have always had an intense antipathy. The mere smell of it makes me feel qualmy, even at the best of times; and it stood to reason that I should dislike it ten times more when my stomach was in an unusually squeamish condition, so that I found it difficult to eat even food that I liked. Hence I looked forward to the impending dose with much trepidation, and reflected anxiously on the probability of my being unable to keep down the nauseous stuff, even when swallowed. It would evidently be a help to avoid having the nasty smell beforehand if possible, as I knew that would make me feel poorly to start with; so I asked Nurse Mary if she would mind pouring out the oil at some distance off and not bringing it to my bedside till all ready to be taken.
She refused roughly, saying she had no time to be bothered with all kinds of fads and whims like that; and, instead of trying to spare me any preliminary unpleasantness, she measured out the dose quite close to my nose, so as to give me a full benefit of the odour. It seemed to me, too, that she was purposely slow in her proceedings, and kept the bottle uncorked for a most needless length of time—but that may possibly have only been my excited fancy.
The oil having been poured into a glass with water in it, I was sat up in bed, the glass was put into my hands, and I raised it towards my mouth. Being already qualmy from the effect of the smell, and very nervous lest I should be actually sick, I was altogether in an unsteady condition; and just before the glass had touched my lips, an involuntary convulsive shiver of disgust that came over me made me for the moment unable to control my muscles. My shaky hand lost its grasp of the glass, which toppled over, and spilled all the contents over me and the bed.
The nurse was as indignant at this catastrophe as if I had done it on purpose. She had not the least pity for the horrible plight I was in, nor did it seem to occur to her how improbable it was for any human being to bring him or herself into such a state willingly. "Troublesome, mischievous, awkward, careless, stupid," were the kindest and least offensive words she uttered whilst preparing a fresh jorum of oil. As for me, I simply endured existence in silent misery as best I could whilst the second dose was being got ready. All I wanted was to take that, and get it over as quickly as possible, so that everything which the filthy oil had contaminated might be removed, and I might be washed, and made sweet, dry, and comfortable again.
When the draught was presented to me, I made a heroic effort, flung it down my throat, and returned the empty glass, murmuring faintly: "Oh please, do make haste to rid me of all this mess!" But what was my dismay to find that she had no intention of doing anything of the kind! Since I had chosen to spill the oil, she said, I might just stop in it and see how I liked it; and perhaps that would teach me not to play tricks of that kind again. What? fetch a clean night-dress and sheet, and a sponge to wipe my face and chest! Not she, indeed! She had plenty of other work to do without extras of that kind; and she had not time to stop worritting with me any longer—I had delayed her quite long enough, as it was. So saying, she coolly walked away, and left me helpless in a sort of castor-oil purgatory.
My misery may be imagined. The cold, clammy, wet linen chilled me; every movement risked bringing me in fresh contact with the loathsome stuff, which I could not touch without a shudder; and the surrounding air was impregnated with its abominable smell. I would have done anything to escape; and if my leg had not been fixed in the cradle, I believe I should have rolled out of bed on to the floor, and as far away as I could go from the hateful spot. But I was powerless to do that, or to lessen my wretchedness by any other means; for I was not strong enough even to pull off my night-dress unaided, nor yet to fold back the wet part of the sheet, and shove it away to the far end of the bed.
Nor was this all I had to suffer; for the smell made my qualminess increase every minute, and I foresaw with dismay that being sick would probably involve a repetition of the dose.
Oh, why could not I escape from this abominable odour? and could I anyhow manage to avoid the consequences with which it threatened me? I remembered having heard it said that sickness may sometimes be checked by a strong effort of will. Let me see if mine would help me in this emergency. I told myself resolutely that the unpleasant sensations which I felt were purely imaginary, and that I need not give way to them unless I chose. And then I tried to turn my mind to various agreeable and interesting subjects, such as Kitty; Mrs. Torwood's dogs; my plan for being revenged on my stepmother, and how I would complete it as soon as I was well again;—anything under the sun to take my thoughts off from this beastly oil! But it was no use. The qualmy sensation forced itself to the front in spite of all I could do; I felt that the dreaded climax was a mere matter of time, and lay awaiting it in terror with my eyes shut. Suddenly I heard some one say: "What a smell of castor oil! Where does it come from?"
The speaker's nose naturally answered this question, and on opening my eyes I saw the good Sister approaching me. This sight gave me a ray of hope that I might still be saved, and she seemed to me to be a very guardian angel. Never would I have believed that the quaint dress which I had often laughed at and considered ugly, obtrusive, and absurd, could have appeared to my eyes so lovely and acceptable as it did at that moment!
She perceived at a glance that the case was urgent, and went to work to relieve me without an instant's delay. Instead of stopping to ask questions (which would have been a needless prolongation of my sufferings) as to how I came to be in such an oily plight, she immediately despatched the nurse to fetch clean things, and herself brought some strong aromatic vinegar and held it to my nose. This neutralised the smell of the oil, revived me, and enabled me to conquer the feeling of nausea. Her timely aid averted the catastrophe I had been dreading, and in a wonderfully short space I enjoyed the felicity of feeling myself purified, and restored to a dry, sweet, and comfortable condition. Not till this had been accomplished did she seem to think of anything else. But then she proceeded to inquire how I had come to be in the state in which she had found me, and to take the nurse to task for having left me so.
The delinquent tried to excuse herself by saying that she had been so exceedingly busy that she had had no choice about leaving me to go and attend to some one else. Besides that, she added spitefully, the accident had been all my own doing, for I had deliberately upset the glass out of mischief.
I was commencing an indignant denial of this falsehood when the Sister interrupted me. She said it was quite immaterial whether the glass had been overturned by accident or not, as there were no circumstances which could justify a nurse for letting a patient remain an instant longer than could be helped in such a state as I had been in—all in a mess, and in wet things that might cause a chill. The alleged press of business was no excuse either; for all the nurses knew perfectly well that they were to ask for assistance if they had too much to do, but were on no account to neglect a patient. She was extremely displeased at Nurse Mary's conduct, and proceeded to rebuke her sharply.
Considering the barbarity with which that nurse had just been behaving to me, it will not be wondered at that to hear her being scolded gave me a sensation of acute satisfaction.
But my gratification was speedily diminished as I recollected that she would probably object to me more than ever, now that I had again been the unlucky means of getting her into a scrape. I was filled with alarm at the idea. If she had bullied me hitherto, what was she likely to do in the future? And what chance had I of defending myself from her malice? I would confide my troubles to the Sister who had already befriended me so often, and ask her to take care of me, I thought. Only I must mind not to let the nurse suspect that I was complaining of her, or she would be still angrier than before with me. I would wait till her turn of duty was over, and some other nurse had taken her place.
After the next change of nurses, therefore, I watched anxiously for the Sister to appear in our ward. At last she arrived there, and I made signs to her to come to my bedside. Then, whispering in a very low voice, so that no one else should hear and report what I said to my enemy, I begged her to protect me from Nurse Mary, who hated me, and treated me so badly that I was afraid of her.
"In what way, and on what occasions, have you been treated badly?" asked the Sister.
It was a most natural question to ask, but it was one that I was puzzled to answer satisfactorily. Though perfectly convinced that I needed to be defended, yet when I began recalling to mind (in order to tell the Sister) the numerous trifling persecutions to which I had been subjected, I found it was by no means easy to discover any grievance that seemed important and tangible enough to take hold of and bring forward in support of my assertions, except the recent castor oil affair, and that she knew of already. I could not recollect anything else that seemed worth erecting into a formal accusation, so I only answered that I could not think of any particular case to mention just then, but that indeed what I had said was true, that the nurse was unkind to me always, and that I was afraid to see her come near me.
"Oh, if that is all," replied the Sister kindly, "I should hope your fears have no real foundation; probably you have taken into your head one of those prejudices that people are very apt to have when they are ill; you must try and get over it, instead of indulging it. But, in any case, you may be sure that I am looking after you, and will see that no one hurts you, so don't alarm yourself about it."
Though she spoke cheerfully and pleasantly, yet still I did not consider my complaint had met with a very encouraging reception; and I was desperately afraid that what I had said would be altogether forgotten, and I should be no better off than before. But she was a person who never turned a deaf ear to any cry for help; and I soon saw that my appeal had not passed unheeded, and that—whether she believed me to be mistaken or not—from that time forth her protecting wing overshadowed me with especial closeness (yet not so ostensibly as to make the fact generally conspicuous) when my enemy was in command of the ward. Not only did the Sister take to coming in and out with extra frequency at these times, but I could perceive also that I was then sure to receive a larger share of her attention than I did on other occasions. And as this kindly, unobtrusive, vigilance made it impossible for me to be made to suffer seriously without her discovering it, my peace of mind was gradually restored.
Thus, thanks to the restraining presence of the Sister, Nurse Mary could not make me as miserable as she would evidently have liked to do; but I know very well that I should have been sadly at her mercy if the Sister had not been there to look after me, for to appeal to the doctor would almost certainly have been worse than useless. I have known people rash enough to do that when they were dissatisfied with their nurses, and the result of their appeals was invariably the same. That is to say, the patient was pooh-poohed with more or less politeness, according to the disposition of the doctor; no attempt was made to investigate the truth of the complaint, and things went on exactly as before, except that the nurses certainly did not increase in amiability towards the individuals who had presumed to find fault with them.
I must say, I think it would be in the interests of the sick, if, in both private and public cases, the doctors would beware of the blind confidence which they, as a rule, are inclined to repose in nurses. My experience is, that if a patient complains of his nurse to the doctor for neglect, roughness, or any other fault, she is apt either to relate what took place so as make it appear that she could not possibly have acted otherwise than she did; or else to deny the charge absolutely; or else to say, with affected compassion, that the poor fellow sometimes wanders in his mind and does not know things rightly, so that it is useless to think of attending to all he says. And the doctor invariably accepts her version as the true one, and takes it for granted that she is all right, and there is no necessity for his interference.
That a doctor should trust much to a nurse is only natural, seeing that there are cases in illness where as much depends upon her as upon him—perhaps even more. But her importance does not make her infallible; and though it is all very well to have confidence in her, yet it is carrying confidence to excess to make it a rule always to think her word better than that of her patient. If a sick person's account of his symptoms differed materially from that given by the nurse, I suppose the doctor would hardly think it wise totally to ignore what had been told him by the former, and to act solely upon the information received from the latter. And ought not the same rule to apply to other statements also?